Goal: To estimate the probabilities of transition among self-rated health states for older adults, and examine how they vary by age and sex. Methods: We used self-rated health (Excellent, Very Good, Good, Fair, Poor, Dead) collected in two longitudinal studies of older adults (Mean age 75) to estimate the probability of transition in two years. We used the estimates to project future health for selected cohorts.
Findings: These older adults were most likely to be in the same health state 2 years later, but a substantial proportion changed in both directions. Transition probabilities varied by initial health state, age and sex. Men were more likely than women to transition to Excellent or Dead. Women were more likely than men to transition to Good or Fair health. Although women aged 70 will have more years of life and more years of healthy life than men, they also have more years of unhealthy life, and the proportion of remaining life that is healthy is slightly higher for men. When observed and predicted Years of Healthy Life (YHL) were compared in various subgroups, the YHL of persons with less favorable baseline characteristics was lower than predicted, and vice-versa. Differences, however, were small (about 5%).
Conclusions: These transition probability estimates can be used to predict the future health of individuals or groups as a function of current age, sex, and self-rated health.
Clinical Trials | Health Services Research | Vital and Health Statistics
Diehr, Paula and Patrick, Donald L., "Probabilities of Transition Among Health States for Older Adults" (January 2001). UW Biostatistics Working Paper Series. Working Paper 171.
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Unpublished Appendix Tables. This technical report has been published as Diehr P, Patrick DL. Probabilities of Transition among Health States for Older Adults. Quality of Life Research 10:431-442, 2001. That published paper provides 2-year estimated transition probabilities among 6 health states (excellent, very good, good, fair, poor, and dead). Two tables are presented, one for persons aged 65 to 79, and another for ages 80 to 100. Here, we present ten appendix tables that were not published with that article. They include estimated transition probabilities in two-year age groups. For example, Table A1 shows 2-year transition probabilities for women initially in poor health. Women aged 65-66 (tabled as 65.5) have a 15% chance of being dead 2 years later, a 35% chance of remaining in poor health, and so on. In contrast, women aged 103-104 have a 56% chance of being dead in two years. The remaining nine tables show estimated probabilities for other initial health states (fair, good, very good, and excellent), and the same set of tables for men. These tables may permit the calculation of more tailored transition probabilities. The estimates for oldest and youngest persons are based on fewer observations and should be used with some caution. The methods for estimating these probabilities are given in the cited publication and also in Diehr P, Patrick DL, Bild DE, Burke GL, Williamson JD. Predicting future years of healthy life for older adults. J Clin Epidemiology 51: 343-353. 1998.